Glibenclamide and metfoRmin versus stAndard care in gEstational diabeteS (GRACES): a feasibility open label randomised trial.

Background: Metformin is widely used to treat gestational diabetes (GDM), but many women remain hyperglycaemic and require additional therapy. We aimed to determine recruitment rate and participant throughput in a randomised trial of glibenclamide compared with standard therapy insulin (added to maximum tolerated metformin) for treatment of GDM.

Methods: We conducted an open label feasibility study in 5 UK antenatal clinics among pregnant women 16 to 36 weeks' gestation with metformin-treated GDM.

Screening and management of gestational diabetes mellitus in Scottish obstetric units: a national survey.

Background And Aims: The last study of screening practices for gestational diabetes (GDM) in the UK concluded that a lack of consensus about screening was due to a lack of clinical guidelines. We aimed to determine current practices in Scotland since new guidelines recommended that diagnosis should be made at a lower level of hyperglycaemia.

Method And Results: An online questionnaire designed to investigate the screening and management of GDM was distributed to all maternity units in Scotland managing women with GDM (n = 15) for completion by relevant clinical team members.

Maternal and neonatal outcomes of successful Kielland's rotational forceps delivery.

Objective: To estimate the rates of early neonatal and maternal complications in a consecutive series of successful Kielland's rotational forceps deliveries.

Methods: This was a retrospective cohort study of consecutive cases of successful rotational forceps deliveries performed in singleton pregnancies at 36 weeks of gestation or more in a tertiary referral center in Scotland, UK, from 2001 to 2008 (n=873). We also compared outcomes associated with successful rotational forceps deliveries in 2008 (n=150) with those of nonrotational forceps delivery (n=873), ventouse delivery (n=159), spontaneous vertex delivery (n=3,494), and emergency cesarean delivery (n=947).

Acute myocardial infarction during pregnancy successfully treated with primary percutaneous coronary intervention.

We report a case of a 40 year old pregnant woman who presented with an acute myocardial infarction (AMI) complicated by ventricular fibrillation. She underwent successful primary percutaneous coronary intervention (PCI). With a tendency towards increased maternal age in developed countries, AMI during pregnancy may become a more frequent occurrence.

Major placenta praevia should not preclude out-patient management.

Objective: To review current management of women with major and minor placenta praevia in view of the recommendations made in the RCOG guideline 2001. To assess whether out-patient care was detrimental to pregnancy outcome.

Study Design: Retrospective observational study at the Simpson Memorial Maternity Pavilion, Edinburgh (a tertiary referral centre).